Began 8/7/18 Will determine: If the number of days intubated (7 days) is correct for needing a formal dysphagia evaluation performed by an SLP If the bedside dysphagia tool is valid in the MICU patient population Steps to follow: Once patient is extubated the RN will call pager 3614 to notify SLPs that there is […]
Category: MICU
Targeted Temperature Management (TTM) in the MICU
HFH MICU will start TTM for patients after PEA and asystolic (nonshockable) arrests who otherwise meet criteria on July 15, 2019 Initially, this will apply to inhouse arrests and out of house arrests that reach the MICU within the TTM window; The ED will start TTM for out of hospital nonshockable rhythms in the near […]
Advanced Hypoxic Respiratory Failure algorithm
The Advanced Hypoxic Respiratory Failure algorithm has been updated to reflect the new data from the ROSE Trial showing no benefit for paralytics. —— Old: (2/5/19) As noted previously, an ECMO consult team has been initiated. Prior to consultation, please refer to the Advanced Hypoxic Respiratory Failure algorithm.
How to stop a patient’s labs from appearing in your inbox
1. Open the chart (doesn’t have to be patient station, just “chart”) 2. Up at top, next top name of PCP is “Care team”. Click the icon. 3. Next to you name, click “end”. Note, you will still get labs on patients where you wrote the order.
Chimeric antigen receptor (CAR) T-Cell Therapy
Please refer to attached education/information for CAR T-Cell Therapy. Heme/Onc will be treating patients with CAR T-cell therapy in the near future and some of these patients will end up in the MICU. Heme/Onc will be available for help but this power-point presentation should be used as a reference.
Procedural Competencey
Outside rotating (i.e. not part of the HFHS) need to have their procedures observed by staff and then need to be given certification in our system. Attached to this post are the competency forms: updated: arterial line competency 05.14.14 (1) central line competency 05.14.14 (1) HFH CCM Procedural Competency Thora and Para endotracheal intubation competency […]
Process for handling Death Certificates outside of normal business hours
Because of the need to process death certificants in a timely fashion, ICU physicians may need to fill out this paperwork during off hours. The cell number to use to call Medical Records for Death Certificates on the weekends/holidays from 8:00 am to 4:30 pm is (313) 229-7627 The process for completing this paperwork is here […]
Fellow MICU Procedural Curriclulum
Procedural skills encompass the areas of clinical care that require physical and practical skills of the clinician in order to accomplish a specific and well characterized technical task. Procedural skill requirements vary according to the context in which procedures are performed and according to the complexity of the required procedure. This curriculum (in concordance with […]
Central venous line removal with SecurAcath clamp
We have recently seen the use of a central line securement device called SecurAcath in patients who were transferred to us from an outside hospital. The key information that needs to be distributed to staff is that these lines have special removal instructions. Staff need to be aware of these removal instructions as they differ […]
Ketamine infusion
As the choices for ICU sedative medications dwindle for a variety of reasons, the following documents may be helpful if a decision is made to use a ketamine infusion. This document outlines guidelines on patient selection for ketamine infusions. This document outlines parameters for a ketamine infusion order that can be cut and pasted into Epic for nursing […]